Trauma and Post-traumatic Stress Disorder (PTSD)

Trauma involves exposure to a catastrophic event, often of a life threatening or seriously physically threatening nature. Traumatic events include experiences such as witnessing violence, being a victim of crime or violence, living through a natural disaster, being a combatant or civilian in a war zone, and witnessing or being been a victim of a severe accident.

Most mental health professionals have expanded the definition of trauma to include betrayal trauma. Betrayal trauma occurs when the people or institutions we depend on for survival violate us in some way. An example of betrayal trauma is childhood physical, emotional, or sexual abuse. Please see Surviving Childhood Abuse for information on this topic.

People who have encountered traumatic events experience distress at different times after the event. Some people may have immediate reactions, whereas others may not have reactions for quite some time, while some others may not have a reaction at all. There is no standard response to a crisis. Some common reactions that people have after a traumatic event:

•Feelings may become intense and sometimes unpredictable;
•You may be more anxious, fearful, hopeless, or irritable than usual;
•You may have repeated thoughts and vivid memories of the event;
•You may feel confused, have memory impairment, or have difficulty making decisions;
•Your interpersonal relationships may become strained(e.g., increased conflict or becoming withdrawn and avoiding your usual activities);
•You may have more physical symptoms than usual, such as fatigue, nausea, sweating, or chills;
•Pre-existing conditions may become worse;
•Sleep might be disturbed and;
•You may have recurrent emotional reactions around the anniversary of the event

Managing Symptoms following a Traumatic Experience

•Give yourself time to heal;
•Ask for support from people who care about you;
•Find out about local support groups—we can help;
•Try to have a healthy diet and get plenty of rest;
•Avoid drugs and alcohol;
•Try to re-establish your regular routines like mealtimes, exercise, hobbies, and fun activities and;
•Try to avoid making major decisions at this time—this will add more stress

Post-Traumatic Stress Disorder

“What if it has been a while since the traumatic event and I'm not getting better? What if my symptoms are more intense than what was just described?” You may be experiencing Post-traumatic Stress Disorder (PTSD). People with PTSD may have few or many of the following symptoms:

•You may have intrusive thoughts, feelings, or images about the event. No matter how hard you try, you can't make it stop.
•You may have flashbacks or nightmares where you feel you are reliving the event. Flashbacks involve a person perceiving him or herself to be in the traumatic situation. An example of this would be a crime victim acting as if he or she is fighting off attackers.
•You may become extremely distressed when something reminds you of the event. A sight, sound or smell can activate memories. For example, getting into a car can be extremely distressing for the victim of a car wreck.
•You may feel extremely on-guard or in danger. You may startle very easily and may be jumpy.
•You may avoid thoughts, feelings or conversation about the traumatic event.
•You may avoid people, places, and/or activities that remind you of the event. For example, crime victims may want to avoid the place where they were attacked.
•You may not feel like participating in your usual activities.
•You may not feel connected to people. You may avoid socializing. It may be difficult to trust people.
•You may feel numb, and may not feel emotions like you used to.
•People with PTSD may experience other psychological difficulties along with the PTSD. These other psychological problems may include depression, anxiety disorders, panic disorder, eating disorders and alcohol/substance abuse.

Seeking Treatment for Trauma

Concerns related to trauma occur on a continuum, may change over time, and can vary from person to person. Due to the often complex nature of trauma, thorough assessment and treatment recommendations are required to insure an individual receives the most beneficial, ethical, and appropriate care for their particular needs. Best practices for the treatment of trauma and Post Traumatic Stress Disorder indicate that recovery is a process and occurs in three phases: Safety and Stabilization, Remembrance and Mourning, and Reconnection and Integration. Trauma survivors may seek counseling at any stage in the recovery process. The Loyola University Counseling Center is able to provide assessment and short-term individual counseling for students whose symptoms following a trauma (either recent or past) are mild to moderate. This may include connecting students with additional campus or local resources, if requested by the student. Consistent with our short-term model, the Counseling Center is unable, however, to provide the full continuum of care to treat individuals struggling with a more significant trauma response or prolonged Post Traumatic Stress Disorder.
Concerns or symptoms that may warrant referral to off-campus treatment providers (either from the start of treatment or following a period of short-term counseling at the Counseling Center) may include:

•Need for sessions more than 1x/week or over an extended time period
•History of multiple traumatic experiences
•Dissociative episodes
•Prolonged depersonalization/derealization
•Chronic suicidal ideation
•Co-occurring severe depression, anxiety, or other mental health concern
•Co-occurring substance abuse

The Counseling Center recognizes that discussing trauma can be difficult and we strive to create an environment of sensitivity, safety and trust. If treatment with an off-campus provider is recommended, the counselor will partner with the student to identify the most appropriate provider and coordinate care with the new provider while the student transitions their treatment. Access to the Counseling Center for an emergency meeting, and assistance with navigating on or off-campus resources remains available to all students throughout their college career, regardless of whether they have been referred to an off-campus provider for on-going treatment.

If you are suffering after a traumatic event, please call the Counseling Center to make an appointment 410-617-CARE (2273).

Loyola University Maryland and Baltimore Resources for Concerns related to Sexual Assault and Partner Violence: